Smoking Cessation Support for Pregnant Women Provided by English Stop Smoking Services and National Health Service Trusts: A Survey
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Service Configuration
3.2. Staffing and Practitioner Consultations
3.3. NRT and Smoking Cessation Aids
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Pineles, B.L.; Park, E.; Samet, J.M. Systematic Review and Meta-Analysis of Miscarriage and Maternal Exposure to Tobacco Smoke During Pregnancy. Am. J. Epidemiol. 2014, 179, 807–823. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Flenady, V.; Koopmans, L.; Middleton, P.; Frøen, J.F.; Smith, G.C.; Gibbons, K.; Coory, M.; Gordon, A.; Ellwood, D.; McIntyre, H.D.; et al. Major risk factors for stillbirth in high-income countries: A systematic review and meta-analysis. Lancet 2011, 377, 1331–1340. [Google Scholar] [CrossRef]
- Moore, E.; Blatt, K.; Chen, A.; Van Hook, J.; De Franco, E.A. Factors Associated with Smoking Cessation in Pregnancy. Am. J. Perinatol. 2016, 33, 560–568. [Google Scholar] [PubMed] [Green Version]
- Cnattingius, S. The epidemiology of smoking during pregnancy: Smoking prevalence, maternal characteristics, and pregnancy outcomes. Nicotine Tob. Res. 2004, 6, S125–S140. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- NHS Digital. Statistics on Women’s Smoking Status at Time of Delivery: England—Quarter 3-2020-21. 3 June 2021. Available online: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-women-s-smoking-status-at-time-of-delivery-england/statistics-on-womens-smoking-status-at-time-of-delivery-england---quarter-3-2020-21 (accessed on 31 January 2022).
- Action on Smoking and Health and Smoking in Pregnancy Challenge Group. Getting Back on Track: Delivering a Smokefree Start for Every Child. 15 April 2021. Available online: https://ash.org.uk/wp-content/uploads/2021/02/GettingBackOnTrack2021-v1.pdf (accessed on 31 January 2022).
- NHS Digital. Statistics on Smoking. 23 June 2021. Available online: https://files.digital.nhs.uk/D9/5AACD3/smok-eng-2019-rep.pdf (accessed on 31 January 2022).
- NHS Digital. Statistics on Women’s Smoking Status at Time of Delivery: England—Quarter 2-2021-22. Available online: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-women-s-smoking-status-at-time-of-delivery-england/statistics-on-womens-smoking-status-at-time-of-delivery-england-quarter-2-2021-22 (accessed on 31 January 2022).
- National Institute for Health and Clinical Excellence. Stopping Smoking in Pregnancy and after Childbirth. 2020. Available online: https://pathways.nice.org.uk/pathways/smoking/stopping-smoking-in-pregnancy-and-after-childbirth.pdf (accessed on 31 January 2022).
- Fahy, S.J.; Cooper, S.; Coleman, T.; Naughton, F.; Bauld, L. Provision of smoking cessation support for pregnant women in England: Results from an online survey of NHS stop smoking services for pregnant women. BMC Health Serv. Res. 2014, 14, 107. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- National Institute for Health and Clinical Excellence. How to Stop Smoking in Pregnancy and Following Childbirth. Available online: https://www.ncsct.co.uk/usr/pub/how-to-stop-smoking-in-pregnancy-and-following-childbirth.pdf (accessed on 31 January 2022).
- Szatkowski, L.; Vaz, L.R.; Fiaschi, L.; Tata, L.; Coleman, T. Trends in prescribing of nicotine replacement therapy to pregnant women in primary care in England. Nicotine Tob. Res. 2021, 23, 1607–1610. [Google Scholar] [CrossRef] [PubMed]
- Action on Smoking and Health and Cancer Research UK. A Changing Landscape: Stop Smoking Services and Tobacco Control in England. 9 March 2020. Available online: https://ash.org.uk/wp-content/uploads/2019/03/2019-LA-Survey-Report.pdf (accessed on 31 January 2022).
- Action on Smoking and Health and Cancer Research UK. Stepping up: The response of Stop Smoking Services in England to the COVID-19 Pandemic. 7 June 2021. Available online: https://ash.org.uk/wp-content/uploads/2021/01/ASH-CRUK-Stepping-Up-FINAL.pdf (accessed on 31 January 2022).
- NHS. The NHS Long Term Plan. 9 March 2019. Available online: https://www.longtermplan.nhs.uk/ (accessed on 31 January 2022).
- Cooper, S.; Orton, S.; Campbell, K.A.; Ussher, M.; Coleman-Haynes, N.; Whitemore, R.; Dickinson, A.; McEwen, A.; Lewis, S.; Naughton, F.; et al. Attitudes to E-Cigarettes and Cessation Support for Pregnant Women from English Stop Smoking Services: A Mixed Methods Study. Int. J. Environ. Res. Public Health 2019, 16, 110. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- IBM Corp. IBM SPSS Statistics for Windows, Version 27.0; IBM Corp.: Armonk, NY, USA, 2020.
- Baruch, Y.; Holtom, B.C. Survey response rate levels and trends in organizational research. Hum. Relat. 2008, 61, 1139–1160. [Google Scholar] [CrossRef] [Green Version]
- NHS Digital. NHS Maternity Statistics, England 2019-20. 4 November 2021. Available online: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-maternity-statistics/2019-20#resources (accessed on 31 January 2022).
- Walker, N.; Howe, C.; Bullen, C.; Grigg, M.; Glover, M.; McRobbie, H.; Laugesen, M.; Jiang, J.; Chen, M.H.; Whittaker, R.; et al. Does improved access and greater choice of nicotine replacement therapy affect smoking cessation success? Findings from a randomized controlled trial. Addiction 2011, 106, 1176–1185. [Google Scholar] [CrossRef] [PubMed]
- Hartmann-Boyce, J.; McRobbie, H.; Butler, A.R.; Lindson, N.; Bullen, C.; Begh, R.; Theodoulou, A.; Notley, C.; Rigotti, N.A.; Turner, T.; et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst. Rev. 2021, 9, CD010216. [Google Scholar] [PubMed]
- Calder, R.; Gant, E.; Bauld, L.; McNeill, A.; Robson, D.; Brose, L. Vaping in Pregnancy: A Systematic Review. Nicotine Tob. Res. 2021, 23, 1451–1458. [Google Scholar] [CrossRef] [PubMed]
- McNeill, A.; Brose, L.; Calder, R.; Bauld, L.; Robson, D. Vaping in England: An Evidence Update Including Mental Health and Pregnancy, March 2020; Public Health England: London, UK, 2020. [Google Scholar]
- National Centre for Smoking Cessation and Training. The Standard Treatment Programme for Pregnant Women. Available online: https://www.ncsct.co.uk/usr/pub/NCSCT%20Standard%20Treatment%20Programme%20for%20Pregnant%20Women.pdf (accessed on 31 January 2022).
- Kruse, G.R.; Rigotti, N.A.; Raw, M.; McNeill, A.; Murray, R.; Piné-Abata, H.; Bitton, A.; McEwen, A. Content and Methods used to Train Tobacco Cessation Treatment Providers: An International Survey. J. Smok. Cessat. 2017, 12, 213–220. [Google Scholar] [CrossRef] [PubMed]
- Thomson, R.; McDaid, L.; Emery, J.; Naughton, F.; Cooper, S.; Dyas, J.; Coleman, T. Knowledge and Education as Barriers and Facilitators to Nicotine Replacement Therapy Use for Smoking Cessation in Pregnancy: A Qualitative Study with Health Care Professionals. Int. J. Environ. Res. Public Health 2019, 16, 1814. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Herberts, C.; Sykes, C. Midwives’ Perceptions of Providing Stop-Smoking Advice and Pregnant Smokers’ Perceptions of Stop-Smoking Services Within the Same Deprived Area of London. J. Midwifery Women’s Health 2012, 57, 67–73. [Google Scholar] [CrossRef] [PubMed]
- Flemming, K.; Graham, H.; McCaughan, D.; Angus, K.; Sinclair, L.; Bauld, L. Health professionals’ perceptions of the barriers and facilitators to providing smoking cessation advice to women in pregnancy and during the post-partum period: A systematic review of qualitative research. BMC Public Health 2016, 16, 290. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bell, R.; Glinianaia, S.V.; van der Waal, Z.; Close, A.; Moloney, E.; Jones, S.; Araújo-Soares, V.; Hamilton, S.; Milne, E.M.; Shucksmith, J.; et al. Evaluation of a complex healthcare intervention to increase smoking cessation in pregnant women: Interrupted time series analysis with economic evaluation. Tob. Control 2018, 27, 90–98. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Regions Covered | LA Services n (%) | NHS Trusts Services n (%) |
---|---|---|
Number of Respondents | n = 99 LAs | n = 30 NHS Trusts |
East of England | 7 (7%) | 3 (10%) |
London | 20 (20%) | 2 (6%) |
East and West Midlands | 14 (14%) | 5 (17) |
North East, Yorkshire and Humberside | 24 (24%) | 8 (27%) |
North West | 9 (9%) | 5 (17%) |
South East | 14 (14%) | 5 (17%) |
South West | 11 (11%) | 2 (6%) |
Staff Providing Smoking Cessation Support for the Majority of Pregnant Women, n (%) | |
---|---|
LAs | n = 99 |
Stop smoking specialist(s) working only or mainly with pregnant women | 51 (51%) |
Stop smoking specialist(s) working with all smokers, including pregnant women | 47 (47%) |
GPs or Pharmacists | 16 (16%) |
Lifestyle/wellbeing counsellor(s) | 7 (7%) |
Other | 27 (27%) |
NHS Trusts | n = 30 |
Stop smoking practitioners who are not otherwise clinically trained | 17 (57%) |
Specially trained midwife/nurse | 16 (53%) |
Specially trained healthcare assistants | 11 (37%) |
Staffing and Support Type | LA Services n (%) | NHS Trusts Services n (%) |
---|---|---|
Number of Respondents | n = 99 LAs | n = 30 NHS Trusts |
What smoking cessation training have Practitioners who see pregnant women undergone? (tick all that apply) | ||
‘Very Brief Advice on Smoking’—online | 60 (60%) | 23 (79%) |
‘Very Brief Advice on Smoking for Pregnant Women’—online | 61 (61%) | 24 (83%) |
‘Stop Smoking Practitioner Training’—online | 76 (76%) | 23 (79%) |
‘Pregnancy and Smoking Cessation’—online | 60 (60%) | 23 (79%) |
Face-to-face training delivered by NCSCT trained staff | 41 (41%) | 17 (65%) |
Don’t know | 12 (12%) | 4 (15%) |
Other | 24 (24%) | 9 (35%) |
How are initial stop smoking support appointments with pregnant women conducted? (tick all that apply) | ||
Individual face-to-face | 70 (70%) | 18 (60%) |
Group face-to-face | 2 (2%) | 0 (0%) |
Remote (telephone/video call) | 80 (80%) | 25 (83%) |
Other | 30 (30%) | 6 (20%) |
How are follow-up stop smoking support appointments with pregnant women conducted? (tick all that apply) | ||
Individual face-to-face | 73 (73%) | 21 (70%) |
Group face-to-face | 3 (3%) | 1 (3%) |
Remote (telephone/video call) | 82 (82%) | 26 (87%) |
Other | 28 (28%) | 5 (17%) |
NRT and Smoking Cessation Aids | LA Services n (%) | NHS Trusts Services n (%) |
---|---|---|
Number of Respondents | n = 99 LAs | n = 30 NHS Trusts |
Does your service have a budget for or provide NRT to pregnant women? | ||
Yes | 84 (84%) | 20 (67%) |
No | 11 (11%) | 10 (33%) |
Missing | 5 (5%) | N/A |
How is NRT supplied to pregnant women? (tick all that apply) | n = 84 | n = 20 |
Direct provision of NRT from your service | 43 (51%) | 11 (55%) |
Voucher for NRT to be redeemed at a local pharmacy | 39 (46%) | 9 (45%) |
GP prescription | 18 (21%) | N/A |
Hospital prescription (i.e., redeemed at hospital pharmacy) | N/A | 1 (5%) |
Other | 9 (10%) | 3 (15%) |
What types of NRT do you offer pregnant women? | n = 84 | n = 20 |
Combination NRT | 77 (92%) | 19 (95%) |
Fast-acting only | 0 | 1 (5%) |
Patch only | 0 | 0 |
Missing | 7 (8%) | N/A |
Number of weeks NRT is offered to pregnant women | n = 84 | n = 20 |
Less than 12 weeks | 10 (12%) | 5 (25%) |
12 weeks | 45 (53%) | 10 (50%) |
More than 12 weeks | 20 (24%) | 5 (25%) |
Not known/missing | 24 (28%) | N/A |
Does your service offer pregnant women any of the following? | n = 99 LAs | n = 30 NHS Trusts |
Provide e-cigarettes, either directly or indirectly, e.g., by voucher | 11 (11%) | 2 (7%) |
Incentives for success in quit attempts, e.g., money, shopping vouchers (please give details of incentives and value below) | 14 (14%) | 5 (17%) |
None of the above | 67 (82%) | 23 (77%) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Thomson, R.; Cooper, S.; Waldron, J.; Mamuzo, E.; McDaid, L.; Emery, J.; Phillips, L.; Naughton, F.; Coleman, T. Smoking Cessation Support for Pregnant Women Provided by English Stop Smoking Services and National Health Service Trusts: A Survey. Int. J. Environ. Res. Public Health 2022, 19, 1634. https://doi.org/10.3390/ijerph19031634
Thomson R, Cooper S, Waldron J, Mamuzo E, McDaid L, Emery J, Phillips L, Naughton F, Coleman T. Smoking Cessation Support for Pregnant Women Provided by English Stop Smoking Services and National Health Service Trusts: A Survey. International Journal of Environmental Research and Public Health. 2022; 19(3):1634. https://doi.org/10.3390/ijerph19031634
Chicago/Turabian StyleThomson, Ross, Sue Cooper, John Waldron, Efe Mamuzo, Lisa McDaid, Joanne Emery, Lucy Phillips, Felix Naughton, and Tim Coleman. 2022. "Smoking Cessation Support for Pregnant Women Provided by English Stop Smoking Services and National Health Service Trusts: A Survey" International Journal of Environmental Research and Public Health 19, no. 3: 1634. https://doi.org/10.3390/ijerph19031634